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SMOKING AND HEALTH 1987 Proceedings of the 6th World Conference on Smoking and Health, Tokyo, 9-12 November 1987 Editors: Masakan Aolci Tuberculosis Institute, Kiyose, Tokyo, Japan SMSeru Hhamkhl Tohoku University School of Medicine, Sendai, Japan Sahetaml Tomisp Aichi Cancer Center Ratuch Institute, Nagoya, Japan ()1988 ~ O EXCERPTA MEDICA, Amstenlam • New Yorh • Oriord ?V W is ~ ~

.Oc 1988 Elsevier Science Publishers B.V. (Biomediul Division) All rights reserved. No pan of this publication may be reproduced, stored in a retrievaJ system or transmitted in any form or by any means, electronic, mectunical„ photocopying, recording or otherwise without the prior written permission of the publisher, Elsevier Science Publishers B.V., Biomedical Division, P.O. Box 1327, 1000 BM Amsterdam, The Netherlands. No responsibility is assumed by the Publisher for any injury andlor damage to per- sons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions or ideas contained in the materi,al herein. Because of rapid advances in the medical sciences, the Publisher recommends that independent verification of diagnoses and drug dosages should be made. Special regulations for readers in the USA - This publication has been registered with the Copyright Clearance Center Inc. (CCC),, 27 Congress Street. Salem, MA 01970, USA.: Inforetnation can be obtained from the CCC about conditions under which photocopies of parts of this publication may be made in the USA. All other copyri=ht questions, including photocopying outside the USA, should be referred to the copyright owrxr, E.lsevier Science Publishers B.V., unless otherwise specified. International Congress Series No. 750 ISBN 0 4<4 80994 5 Published by: Elsevier Science Publishers B.V. (Biomedicat Division) P.O. Box 211 1000 AE Amsterdam The Netherlands Sok distribr+tort for the uSrt atd Cwwdd: Elsevier Science Publishin: Company Inc. 52 Vaadabih Avenue New Yoric. NY 10017 USA Lfbmy of Co+ttAM CotdoZins rn Pub&uio+t Drtst: 11M11 CllowM" .ftwo" w bM:rtO feM . IM! , TMIw. iDYRl sta$" w.fealM W7 , irMMOsM N MIe Mf sw/.OMKMMf ~ Mli.s a" 1M Mta. TMN. F t! 11Norar 1Mt !N ItYt.. MMm fte/. •1gerv M/8M/rf, solfM/. TM/"". 0. tn. ~ t~t~YtNrl w»rMN. w.Ns I r. 7r1 t NwrM~. !s* F~i /tl.8./ tK s.M~I" sissttt-dl+rsses. i. YU.IMMow. n. M/Ml1ea/. s1"n.. zu. TM1YM.. SuMMt. IY. TIt1N. . !.. lass I.~yrMnt /M a sMtM ti Mtaf.T~lw Ir7 4M.M'F-"1s OW~t ..r 1.1r.rs .. a.e... .a-rwI Printed in 7Ue Nesbalaads C°

WCT;^, E This materl;; may be protected l-y copyrfght law (Title 17 U.S. Code). 1988 Eise-er S:xnae Pubhshere B.% ' rBiomedfcal Doioonl SmokinQ and health 198' M. Aok ei al, editors 483 le;artment of °.;:ideniolor,y,°ianjin Vedical ^ollege.^ian,4in(T.q.•^.hina) '"here io still controversy about the relntionsh,Yp between cigarette smoY.ing and fem-ale lung cancer.The mortality rate of female lung can- cer in ^ianjSn is the highest in :hina(28.3/105).The female snoking rate in °ianjin is nlso the highest in ^.hina.':here•ore we Msd con- ducted a case-control study of fecale lung cancer to illustrate it. !'lt:':'FiIwL AND Mr'T??COS ve condvcted a t:t pair mtched ease-control study. t.Onses:t57 female lung cuucer esses all resident in :ian4irr zcre than, 10 years. Squacous cell carcinoaa 35(22.'%):Sma11 cell, carcinoma 31(19•7%)tAdenocarcinoma 58(36.9!.);Large cell careino^.a 4(2.5'G);^ell type unknown 29(i8.51). ^•aaes were 3iagr:osed:t33(64.7K) histologica:- ly or cytologically;i7(t0.e%) by ^'";7(4.5x) clinically or by T-ray. 2.^.ontrols;157,=tched with s'x,race,aa,e(=2 years)a:d marital, sta- VIs. nrS'ZTS t.The case group is a quite representative of the '"iar.4i-s female lung cancer. The age group structure and distri'bution of r9sidents of the lung cancer group is quite si^.ilar v:*.ti those of 1983 Tianjin •e- male lung "::cer. Smoking rate of the control group(40.8:) is quite similar with that of ths Tianjin adult female populatlon(39.5% 338.'). 2.The age,education,oecupatlon,race.maritall status.birth place.resi- dent place of the case and control groups have no significant dif- ference(P > 0.05). 3.°emale lung cancer and active amoking +Wqp9qMftni 1ftkW Ait-Jf`41P (Table t,). TABL? S.OTi 0° StlQffiNG gxpos!u" r.tap of casee. ~-65•6!~ on ra Ts Smoker Nonsmoker .656(3.05 -t), 8soker 45 58 PAR%-•656(3.05-t a'S7.1~ Cssesl(on- smo er 19 35 1 r~ ~s Rnito_~Mtftis 4oM-*ffeot~ 'QR-3.05, 95%CI=1.77-5•30 rfLtion t ip 'ket+r•s[ 3mg oanC*r-Y~ Y '• Ad~natsd OIt~2.6.95~ CI~t .4-4.6# rl~sk ~esd ~ba'eff' biasrrttea smoked :~ p<o.00t and'rar of isokicifTaDl~ ~)~

484 OR is higher of those smoking deeper than those s^oka superficiaLLlq or non-smoking (Table 3). OR is higher among those atert smoking .ar- lier (*:ble 4). T.tEL? 2.L:73 CANCM RISK. AND N0.0° TABLr 3. OR AND DFGR49 0P IN- CIIA.R?T^.'?S AND YRA R OP SMO$'iNG FiALATIOK(K-R )'L°THOID) % OR 95% CI of OR No Occasional Deep day rettes Case 54 37 66 Control 98 33 26 1- 1.81 1.40-2.33 11- 3.27 2.26-4.68 OR 1 2.03 4.61 21- 5.9Q 3.79-9.18 P <0.01 Year of smoking 0 1 1- 5.73 1.38-2.18 20- 3.00 2.17-4.16 40- 5.20 3.49-7.75 TABLR 4. CR AND AGS ONS?T 0F SM(+KING (M-R M4TROD) Age Group Non-smoking 21 16-20 15 P <44 Ca3e 8 1 3 0 > 0.05 Control 12 0 1 0 45-Case 16 8 17 14 C 0.01 Control 29 9 14 3 55-^asw 24 13 13 115 <O.Ot Control 35 t8 6 5 6 5-Case 6 6 6 7 <0.01 Control 17 4 2 2 OR 1 1.59 3•10 6.3 1CO•01 4.Pomalv lung cancer and paszsiv+e smoking. tif had otlculated the OR of pa9si pAjqg_jM_bpsbsnd father.mo- thor and oolleagues.Mlj Ahtt 1=o..hnshen4 1s ,4nitt signiiiaemt. ~ The nao-adokias femalo cas.s and oontrols rith smokin; or non-saok- ir>a hnaband is as tsble 5. 1M, dtILs_ 2.'S6 {ZsO.OS)7 T48L13 5• O8 O! "LIlfG l19s8A11D TO t0<-SROLIItO YIPs E:posurt rsto of oaseo -- -0 63 p 8usti:n3 . 3 .W ssok.r Non-smoker ~ PAO' Caso 34 20 . 63( 2. t -t Control 41 52 oi tiail: iao~ e.cio:r"~a- ~f oR-2.16.95'4 CI-1.03-4.539 fr6ftsoe Kth th* n>abor of eigar-~3r_ P<0.05

485 3 Df Rxposure ZD her hueb.nd I • simo',cing(,able 5)•~? 5•CR of either active or Faasi'.•e and combination of active and pas- sive snoki "A_--? 6.C? .,;:T'4R C^ ng i Cv s as table 7. r:YL.Lr LT•MO efi?5:,t7 TABLE 7.CR Or A.':I7s AND 'ASSI7? ST!c'KI`;;. L'RO!!r LiT'SBA3,'0 :BA:J fR o5'V:I C° OR - ., SFCi'?:I~ ~C ~S ; ;AR ;"" . -qR DAY EP'SBAh'0 110 1.C 2. 61 (1 .4-4 .6 ) 0 1 SM.OKING TVS 1.66(1.04- 4.90(1.8-9.5) 1- 1.40 1.12-1.76 3.5) 10- 1.97 1.42-2.72 20- 2.76 1.85-4.10 If a smokino woman with Smoking t:us- 1^-.A' S C" '.q: 0 1 band,the OR of lung cancer is 4.9,expo- sure rate is 814 (83/103). 1- 1.49 1.t5-1.94 0 4 20- 2.23 1.54-3•22 . ,- ~ .75.95%• P1.R. ~Bi' 4C- 3.32 2.11-s.22 A non-smoking woman with smoking husband,the CR of lung cancer is 1.86,exFosure rate is 63% (34/54). FA?i, .630.86-1 ) . '35.1%. aacording to 103 smoking female Lsna cancer cases about 78.23(10= X .7595) are due to 3moking,whil^ the 5a non-smoking female lung cancer casea about 18.95(54X.351) are due to =ASSi~r~ rcvi.^.- '-o- 6,!r b-:nd. That Ys 78~2 .t8'95-61.~yi of female lsng cancer in Tisn3in may at- e t-ibu*.e to active smoking and passive snoking from their husbands. 6. OR of female lung cancer due to other causes. Occupational exposure: Textile sorkers,workers expose to asL•::tos, benzene,etc. CR-3.1.95% CI-1.58-6.02. OR of history of lung diseases (inclu~'j pulmonaiy "_"HC,chronic bron- chitis,puimonary infeetion.etc.)ia 2.64.Adjusted with conditional re- gression mode:l,0R-2.12.954CI of OR.-1.23-3.63• OR of lung cancer and cooking with coal is shown in table 8. 7. Joint :ffect of the• ?t,isk *actore. Multifactor analysis by conditional regression method demonstrate that tht combination of active smokiog.passive saokina from husbands, occupationai expoeure.history of lung diseases and 4 X10a hours cook- ing with coal makes the OR being about 50 in comparison -ith thosa

486 vithou: the above risk factors and cooking with coal less than 3X1G4 hours. 954 :I of OR013.T-185•3• ^: 3L? B. OR OF Lt;t;; An ZOORING WI:"1t' ^OAL ~'r..a:".^!? 0* :OOKIN,(hrs); OR 95% ^-2 of OR tx11.5 hr/day.20 yrs) 1.54 1.20-1.96 2x104(t.5 hr/day,40 yrs) 2.36 1.66-3.34 3xti04(2 hrs/day.42 yrs) 3.62 2.36-5.55 4X104(3 hrs/day,37 yre) 5.56 3.40-9.10 "NCL^SPON 1.1,4oth aative smoking and passive smokin,; :ror^ hir huaband are the ®ost important risk factors of female lung cancer in Tianjin. About 604 of female Lung cancer in Tian~in may be attributed to g*.oY.ing. 2. There := joint effect of a:noking with occupational exposlire,hit- tory of lung diseases and cooking with coal. R?"`-7R?NC?S 1. Hiraynma T(198i) Brit Med J 282:183 2. 7Cu Hti,3eng f3Y (1983) Chinese J°pideclnl 4:193-197 3• let>S %T (1980) In: 3eng ^,Y (eds) ",Fideniology•7eople's ;!edical Fubliahing House,3eijing, vol I, pp 153-158,188-19t